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These medicines reduce or modify immune activity in autoimmune disease and transplant care. Treatment is condition-specific and usually requires specialist oversight, laboratory monitoring and infection precautions.

Plaquenil

Hydroxychloroquine

200 · 400mg

Hydroxychloroquine 200mg and 400mg film-coated tablets, used in the management of rheumatoid arthritis and systemic lupus erythematosus. A DMARD.

From$0.53/ tabletView

Methotrexate Tablets

Methotrexate

2.5mg

Methotrexate 2.5mg tablets, used in the management of rheumatoid arthritis, psoriasis and Crohn's disease. A folic acid antagonist blocking dihydrofolate reductase.

From$0.73/ tabletView

Olumiant

Baricitinib

4mg

Baricitinib 4mg film-coated tablets, used in the management of rheumatoid arthritis, atopic dermatitis and alopecia areata. A JAK1 and JAK2 inhibitor.

From$119.00/ tabletView

Arava

Leflunomide

10 · 20mg

Leflunomide 10mg and 20mg film-coated tablets, used in the management of rheumatoid and psoriatic arthritis. A DMARD that blocks pyrimidine synthesis.

From$1.54/ tabletView

Prograf

Tacrolimus

0.5 · 1 · 5mg

Tacrolimus 0.5mg, 1mg and 5mg hard capsules, used in the management of transplant rejection. A calcineurin inhibitor that holds T-cells back.

From$3.75/ tabletView

Protopic

Tacrolimus

0.03 · 0.1%

Tacrolimus 0.03% and 0.1% ointment, applied to the skin for atopic dermatitis. A calcineurin inhibitor rather than a topical steroid.

From$15.13/ tubeView

Imuran

Azathioprine

25 · 50mg

Azathioprine 25mg and 50mg film-coated tablets, used in the management of transplant rejection, rheumatoid arthritis and lupus. A purine analogue.

From$0.85/ tabletView

Neoral

Ciclosporin

25 · 100mg

Ciclosporin 25mg and 100mg soft capsules, used in the management of transplant rejection, rheumatoid arthritis and psoriasis. A calcineurin inhibitor.

From$4.82/ tabletView

Cyclomune

Ciclosporin

0.05 · 0.1%

Cyclomune is ciclosporin 0.05% and 0.1% eye drop emulsion for keratoconjunctivitis sicca. A calcineurin inhibitor that damps T-lymphocyte activation.

From$40.46/ bottleView

Cellcept

Mycophenolate Mofetil

500mg

Mycophenolate mofetil 500mg film-coated tablets, used in the management of transplant rejection. A prodrug of mycophenolic acid, and an immunosuppressant.

From$4.50/ tabletView

Rapamycin

Sirolimus

1mg

Sirolimus 1mg tablets, used in the management of transplant rejection. An mTOR inhibitor that holds T-cells and B-cells back from activation.

From$3.96/ tabletView

Key points

  • Immunosuppressants and disease-modifying antirheumatic drugs differ in onset, monitoring, pregnancy risks and effects on infection defence.
  • Blood counts and liver, kidney or medicine-level tests may be needed before and during treatment.
  • Do not stop a transplant or autoimmune medicine without the treating team, because disease flare or transplant rejection can be serious.

Listings are for comparison and general information, not a treatment recommendation; suitability and supply depend on specialist, clinician and pharmacy checks, prescription requirements and monitoring.

How the medicine groups differ

Tacrolimus and ciclosporin require careful interaction and, in many cases, blood-level monitoring. Azathioprine, methotrexate, leflunomide and mycophenolate mofetil have different organ, blood-count and reproductive risks. A medicine may have roles in more than one condition, but its monitoring plan is not transferable.

What these medicines are used for

This category includes medicines used for rheumatoid arthritis, systemic lupus erythematosus, psoriasis and prevention or treatment of transplant rejection. What they share is a damping effect on immune activity, but they differ widely in how selective that effect is, so one is rarely interchangeable with another. The diagnosis, not the category, decides which is appropriate.

Important safety checks

Tell the treating team about infection symptoms, vaccination plans, pregnancy or pregnancy planning, and every medicine or supplement. Live vaccines may be unsuitable during some treatments. Avoid changing brands, formulations or timing of transplant medicines without specialist and pharmacy confirmation.

When to seek urgent care

Seek prompt medical care for fever, breathing difficulty, a painful spreading rash, unusual bruising or bleeding, severe mouth ulcers, jaundice or markedly reduced urine. Transplant recipients should urgently contact their team for missed doses, persistent vomiting or possible rejection symptoms.

Further reading

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